Robin R Varghese, PT.
Physical therapy and Rehabilitation!
According to the World Health Organization (WHO), rehabilitation is one of the essential components of Universal Health Coverage (UHC), which features alongside “promotion of good health, prevention of diseases, treatment and palliative care”.
Rehabilitation focuses on achieving functional independence in activities of daily living (ADL), participation in work, recreation and education, with individuals being able to achieve meaningful roles in daily life.
Rehabilitation aims to restore, compensate, prevent or slow deterioration in functioning (sensory, physical, intellectual, mental, cognitive, or social) to help individuals to reach their optimal levels.
WHO defines rehabilitation as:
"a set of measures that assist individuals who experience, or are likely to experience, disability to achieve and maintain optimal functioning in interaction with their environments.”
Rehabilitation occurs across the life-course, from newborns to end-of-life, can occur from before a health condition (preventative ‘prehabilitation’, promotive), in acute care, and post-acute to long-term care and that rehabilitation interventions are provided by many health and non-health professionals, as well as individuals, their families and care takers.
There are four elements of rehabilitation in relation to people with cancer. These elements are now being utilized and applied across rehabilitation for a wide range of conditions.
The elements are:
Occurs shortly after a new diagnosis or onset of new impairments. The aim is to provide education, advice and interventions to prevent or slow onset of further impairments and maintain a person’s level of ability. This is a common form of rehabilitation in long-term conditions, such as Cancer, Chronic Obstructive Pulmonary Disease (COPD), Diabetes and many neurological conditions.
Restorative rehabilitation focuses on interventions that improve impairments such as muscle strength or respiratory function and cognitive impairment to get maximal recovery of function. This is a common form of rehabilitation after surgery, illness or acute events such as a major trauma or a stroke in order to maximise function.
Supportive rehabilitation increases a person’s self-care ability and mobility using methods such as providing self-help devices and teaching people compensatory strategies or alternative ways of doing things. This may include the provision of assistive equipment or environmental modifications. This is sometimes referred to as adaptive rehabilitation.
Palliative rehabilitation enables people with life limiting conditions to lead a high quality of life physically, psychologically and socially, while respecting their wishes. It often focusses on relieving symptoms, such as pain, dyspnoea and oedema, preventing contractures, breathing assistance, psychological wellbeing, relaxation or the use of assistive device, in order to maximise functional independence and support comfort, dignity and quality of life.
The Objectives of Rehabilitation are:
Prevention of the loss of function
Slowing the rate of loss of function
Improvement or restoration of function
Compensation for loss of function (compensatory strategies)
Maintenance of current function
Focuses on good outcomes that are set by the people we treat and driven by their goals
Centers on people’s needs, not their diagnosis
Aims high and includes vocational outcomes
Is an active and enabling process – not passive care
Relies on interdisciplinary team working
Responds to changes in people’s needs
Integrates specialist and generalist services
Requires leadership for transformational change
Scope of Rehabilitation
Develop New Skills
Maintain Skills and Independence –
Recover from Unexpected Illness
Recover from Major Trauma
Manage Long-term Conditions
Are there any misconceptions about Rehabilitation?
Rehabilitation is only for people with disability
Fact: Rehab is for anyone with a health condition, Impairment or injury, cute or chronic, that limits functioning.
Rehab is only a highly specialized service for athletes or a post injury return to work service .
Fact: Rehab addresses the need of a broad scope of people across the lifespan.
Rehab is a luxury health service that can be ignored in the face of competing demands for investment and resources
Fact: Rehab is a core component of health and is also often needed to achieve and maintain the best outcome from other health inventions such as surgery.
Role of Physical Therapy in Rehabilitation
Physical Therapists are licensed health care professionals providing services in a variety of health settings such as hospitals, clinics, nursing homes and other health agencies where they work as part of multi-disciplinary health teams.
They also play key roles at fitness facilities and schools and they make significant contributions to the development of sports and the management of sporting injuries.
The American Physical Therapy Association(APTA) is the professional organization that represents the interests of physical therapists, assistants and students.
Physical Therapists also operate as members of health service provider or rehabilitation teams or as independent practitioners.
The aim of rehabilitation is "to take the patient from the bed to the job". To achieve this end a large team-organization is necessary. As a member of this team, the physical Therapist plays a very important role by being an intelligent and cooperative member of the team.
The physical Therapist assists in the Rehabilitation planning by identifying the nature, extent, of the problem faced by the patient.
They play a very important part in teaching the detailed exercises essential to this method. They evaluates the patient, plans personalized and detailed exercise programme for each patient, assist patients and trains them when they require supportive devices.
They evaluate the treatment outcomes as program implementation progresses.
Emphasis is placed on patient education and training to ensure that the patient becomes independent as soon as possible.
Besides all these duties, the physical Therapist must keep accurate records of the patient's progress and share with the concerned, whenever it is necessary.
The physiotherapist determines the interventions and manages the needs of the individual based on the examination, evaluation, diagnosis, prognosis, plan, anticipated goals and expected outcomes of the planned interventions for identified impairments, or restrictions.
What are the interventions used?
The interventions include the following, But not limited to these alone.
Functional training in self-care, home management, work, community and leisure
Manual therapy techniques (including mobilization/manipulation)
Prescription, application, and fabrication of devices/equipment (assistive, adaptive, orthotic, protective, supportive, prosthetic)
Airway Clearance Techniques
Integumentary repair and protection techniques
Physical agents and mechanical modalities
Physical Therapist plays a very important role in Rehabilitation process as they support people at all stages of life to recover from injury, reduce pain and stiffness, increase mobility and movement and maximize function and quality of life, thereby incorporating physical, psychological, emotional and social wellbeing.
Physical Therapists offer rehab under different names like Cardiac Physical Therapy, Neurologic Physical Therapy, Orthopedic Physical Therapy, Stroke Physical Therapy, Sports Physical Therapy, Post surgical physical therapy, Pediatric rehab, Geriatric rehab etc. and at different set ups like hospitals, homes or in clinics.
At Valley Healing Hands, Brownsville, Texas, we provide the best Physical Therapy Rehabilitation services and go beyond out limits to make sure that our patients thrive back to high quality of life with maximal recovery. Our patients are totally satisfied with our services and you may read what they have to say about us here and get connected to us here. Our patients love us and you too will!!!